North-south divide on commissioning uptake

Take-up of incentive payments for practice-based commissioning (PBC) in the Midlands and north of England is at only three quarters of the level in the south and east, DoH data show.

GPs have warned that an NHS postcode lottery could emerge if the trend continues.  

The data also show that SHAs have fallen behind on August tar-gets for the number of PCTs im-plementing PBC. Three out of four GP practices in England — a total of 6,260 — are now receiving incentive payments for PBC.  

However, average take-up in the five northern and Midlands SHAs is 63 per cent, compared to 84 per cent in the south and east.

The highest rate of take-up is in London, with 86 per cent of practices now receiving incentive payments, compared to 60 per cent in the North East and West Midlands SHAs.  

GPC member Dr Trefor Roscoe said PBC was intended to prevent postcode lotteries, but could have the opposite effect if interest varied wildly across the country.  

‘If there is a large discrepancy between parts of the country, that may alter service provision in ways we can’t predict. It will create inequalities if there are different levels of uptake in different regions,’ he said.  

Dr Roscoe said local factors, such as groups of GPs actively setting up commissioning consortia, could influence take-up.  

PCT implementation of PBC is also behind schedule. Six out of the 10 English SHAs reported fewer PCTs meeting criteria for PBC in August than planned.  

PCTs are judged to be imple-menting PBC if they provide practices with indicative budgets and clinical activity data, as well as offering incentive payments.  

GPC negotiator Dr Richard Vautrey said limited change to NHS organisations in London had helped PBC. 

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